Table 1.

Adaptations to the cancer rehabilitation and survivorship program

Appointment Type	Usual Care	Context and Content Modifications
Comprehensive assessments	Format: appointment includes an initial screen with an OT or PT, followed by an assessment with a MD (physiatrist). Setting: patients are seen in person. Content: patients complete electronic questionnaires in person, and moderate to high distress scores are flagged on a clinician report for the oncology team to assess. Assessments are guided by objective measures including a surveillance physical examination. Appointments include a comprehensive rehabilitation assessment and care plan based on a patient’s identified impairment, level of disability, and personal goals. Appointments are booked for a total of 1.5 h.	Format: no change. Setting: adapted to video or phone. Tailored elements: (1) questions within standard distress screening questionnaires could be used as probes to guide the assessment, but summary reports were not available because a remote system had not been implemented within the cancer center; (2) physical tests and assessments were demonstrated and described to allow patients to complete them on their own; and (3) objective measures of function were not completed. Pacing/timing: no change was made to the scheduled appointment duration.
CaRE@Home	Patients are referred to the CaRE@Home program based on their comprehensive assessment. Format: initial 1-on-1 visit with an RKin, and follow-up visits at 8 wk and 3 and 6 mo. Setting: all assessments are conducted in person. Weekly counseling is delivered via phone. Content: in-person visits include a fitness assessment (6-min walk test, hand grip dynamometry, body composition, balance) and distress reports via questionnaires completed in person. Patients are supported with exercise Therabands, e-modules for education, a mobile application and wearable technology, and weekly brief telephone counseling. Assessments are booked for 1.5 h and weekly counseling is scheduled for 20 min.	No change to the referral process. Format: no change. Setting: all assessments were switched to phone or video. Weekly counseling could now be delivered over video. Removed elements: (1) fitness assessment (6-min walk test, hand-drip dynamometry, body composition, 30-s balance); (2) provision of exercise Therabands; and (3) provision of wearable technology. Tailored elements: (1) exercises were demonstrated and described by the RKin over video, over phone, or through online instructional videos and (2) patient-reported outcomes were completed online at assessment timepoints, but summary reports were not available. Pacing/timing: no change was made to the scheduled appointment duration.
CaRE@ELLICSR	Patients are referred to the CaRE@ELLICSR program based on their comprehensive assessment. Format: initial 1-on-1 visit with an RKin, weekly group classes for 8 wk, and 1-on-1 follow-up visits with an RKin at 8 wk and 3 and 6 mo. Setting: all visits and classes are conducted in person. Content: patients receive an initial assessment and exercise prescription. Assessments include objective measures and distress reports via questionnaires completed in person. Group classes consist of supervised exercise and skills management education. Patients are supported with exercise Therabands, a mobile application, and wearable technology to track activity. Assessments are booked for 1.5 h. Weekly exercise and education classes are 60 min each.	Patients currently enrolled in the CaRE@ELLICSR program were switched to CaRE@Home. All future groups were suspended. Format: weekly supervised group exercise classes were modified to individual weekly 1-on-1 telephone or video calls with an RKin for the remaining weeks of the program. Group skills management education was modified to individual online education. Setting: in-person assessments were adapted to video or phone. Education content was delivered via e-modules. Removed elements: (1) fitness assessment (6-min walk test, hand-drip dynamometry, body composition, 30-s balance). Pacing/timing: no changes were made to the scheduled duration of assessments.
OT and PT follow-up	Format: a 1-on-1 visit with an OT or PT. Setting: primarily in-person; however, OT consults could be delivered via phone. Content: assessments are guided by distress reports via questionnaires completed in clinic prior to the appointment and objective measures (eg, hand grip dynamometry, sit to stand, range of motion). Appointments are booked for 45 min.	Format: no change. Setting: all appointments were delivered via phone or video. Tailored elements: (1) questions within standard distress screening questionnaires could be used as probes to guide the assessment, but reports were not available and (2) physical tests and assessments were demonstrated and described to allow patients to complete them on their own. Removed elements: objective measures of strength and function. Pacing/timing: no change was made to the scheduled appointment duration.
Manual lymphatic drainage	Format: a 1-on-1 visit with a PT or RMT. Setting: patients are seen in person. Content: treatments include manual lymphatic massage, compression bandaging, kinesiotaping, and education. Appointments can be booked for 30 or 60 min.	Format: no change. Setting: adapted to video or phone. Removed elements: objective measures of lymphedema. Substituted elements: manual therapy was postponed, and patients were provided with online resources for manual lymphatic self-massage (videos and pamphlets). Pacing/timing: no change was made to the scheduled appointment duration.
NC, SW, and RD consults	Format: a 1-on-1 visit with the HCP. Setting: primarily in person; however, all visits could be delivered via phone. Content: assessments are guided by distress reports via questionnaires completed in clinic prior to the appointment and objective measures. Appointments are booked for 1 h.	Format: no change. Setting: all appointments were delivered via phone or video. Tailored elements: questions within standard distress screening questionnaires could be used as probes to guide the assessment, but reports were not available. Removed elements: (1) objective measures of body composition for RD appointments and (2) neuropsychological testing. Pacing/timing: no change was made to the scheduled appointment duration.
Education classes	Format: group-based. Setting: in person. Content: monthly 1-h classes. Topics included return to work, brain fog, lymphedema, and sex and intimacy.	Format: group format was postponed because additional time was required to adapt the content of the classes to a virtual format and ensure privacy concerns were addressed. Patients registered for an upcoming class were contacted by the class lead and offered a 1-on-1 appointment or other resources. Setting: adapted to video or phone consults or online resources. Substituted elements: resources included previously developed e-modules for return to work and brain fog classes, as well as a pamphlet on lymphedema management. E-modules on lymphedema and sex and intimacy were in the process of being developed.
Wellness group classes	Format: group-based. Setting: in person; however, cooking classes were streamed live online for patients. Content: classes included cooking and nutrition demonstrations, mindfulness meditation, and gentle therapeutic exercise.	Format: in-person classes were postponed. Setting: patients were directed to online videos and resources available on the program website and external mediums. Tailored elements: cooking and nutrition classes were streamed live without an in-person audience. Removed elements: (1) mindfulness meditation and (2) gentle therapeutic exercise.

Abbreviations: MD, medical doctor; NC, neurocognitive; OT, occupational therapist; PT, physiotherapist; RD, registered dietician; RKin, registered kinesiologist; RMT, registered massage therapist; SW, social work.